What do programs like google x do to promote innovative thinking among its employees?

Am J Public Health. 2015 March; 105(Suppl 1): S114–S118.

Abstract

Innovation is the engine of scientific progress, yet we do not train public health students to think creatively. I present the key concepts within an evidence-based method currently taught at the University of Texas.

Habitual thought patterns involve deeply held framed expectations. Finding alternatives generates originality. Because frame breaking is difficult, a series of innovation heuristics and tools are offered including enhancing observation, using analogies, changing point of view, juggling opposites, broadening perspective, reversal, reorganization and combination, and getting the most from groups. Gaining cognitive attributes such as nonjudgment, willingness to question, mindfulness, and plasticity is also emphasized.

Students completing the class demonstrate substantial increases on a standardized test of idea fluency and originality, more joyful attitudes toward science, and more pluralistic approaches.

Americans love innovation. A Google search on the word in Spring 2014 yielded 118 million hits, similar to the number of hits for the terms “girlfriend” or “boyfriend.” Loving something or someone implies that we crave its presence and fear its loss. A 2010 survey of 1500 chief executives conducted by IBM’s Institute for Business Value found that the attribute they most valued on their leadership team was creativity.1 Research universities, too, consider innovation to be of central importance, indeed the centerpiece of their very mission. The first lines of the influential 2012 National Academies of Science report, Research Universities and the Future of America, read

America is driven by innovation—advances in ideas, products, and processes that create new industries and jobs, spur economic growth and support a high standard of living, and achieve national goals for defense, health, and energy. . . . Our nation’s primary source of both new knowledge and graduates with advanced skills continues to be its research universities.2(p1)

Yet, despite America’s reverence for innovation, we are not faring well in maintaining global supremacy in this arena. The European Union surpassed American scientific output (measured by number of peer-reviewed publications) in 1995, and Asian-Pacific countries did so in 2008.3

More significantly, despite major advances in information and communications technology, we must ask whether the reason why scientific progress has been slow in addressing critical threats to humanity (e.g., climate change, energy sufficiency, water scarcity, hunger, Alzheimer’s disease, obesity, and emerging infectious diseases) is for lack of originality. Another National Academies of Science report, The Gathering Storm, warned that American science is losing its creative ecosystem.4 Together, these reports’ recommendations included more funding for America’s scientific universities, more rigor in secondary-school science education, and more partnerships with industry to commercialize discoveries.

Calls for more funding, rigor, and entrepreneurship imply that innovation is innately present and will flower with the offering of more incentives and better information. I believe that to overcome humankind’s greatest challenges, we need radically different approaches. Although evolutionary or step-wise innovation is widespread and simply needs nurturance, revolutionary innovation is rare. Moreover, because radical novelty typically shatters existing beliefs and business models, it is often initially dismissed or rejected before it is accepted.5 Examples include the notion that handwashing mitigates disease spread by Semmelweis, concepts of classical genetics by Mendel, the association between lead and neurocognition by Needleman, and the linkage between nutrition and pellagra by Goldberger, to name but a few.6

The process by which revolutionary ideas can be generated is not natural and is not easy. Occasionally, disruptive innovation appears de novo as an exceptional trait, such as in creative geniuses. But it can also be developed through training. Decades of research have demonstrated that creativity can be taught.7,8 Carefully crafted creativity-training programs have been developed predominantly for K–12 educational settings. Evaluations of these programs are now sufficiently plentiful that large meta-analyses have been published, showing substantial and consistent success. In one analysis of 40 creativity-training programs6 and in another of 70 creativity-training programs, participants increased the number and originality of the ideas they generated by 2- to 3-fold.9,10 Creativity-training programs equip students with discrete tools. They explain through examples and involve meaningful, disciplinary-specific rehearsal, because to become expert at any skill requires practice. In the few studies evaluating their success in business settings, training led professionals to demonstrate a greater preference for novel problem-solving and more flexibility in work performance.11,12

In each of the 4 years I have taught innovative thinking at the University of Texas School of Public Health to health science students, pretest versus posttest results on a standardized test of creativity (Torrence Test of Creative Thinking) revealed 2- to 3-fold increases in the generation and originality of ideas (the degree to which solutions to a particular problem were nonnormative—i.e., infrequent within a distribution of offered solutions).11 Qualitative data also suggest that the class has benefits. Students consistently tell us that after taking the class they are more curious and excited by science, research supervisors report that students are bringing surprising solutions to their work, and mentors describe many instances of students initiating new and unexpected partnerships. Students come into the class with a range of innate predispositions to creativity, just as they have susceptibilities that enhance or diminish responses to any environmental exposures. The experience “lifts almost all boats”; some students reach a higher level of appreciation and acceptance of originality whereas others become quite talented at novel idea generation.

The pedagogy of innovation training is not strongly linked to content, except that evaluation studies show that domain specificity is important. Because creativity training for sciences should draw on examples and practice from science rather than from art or music, the training program outlined here was specifically developed for science settings.

In this article, I outline select components of a toolbox taught in the innovative thinking curriculum. Greater insight and opportunities for practice can be found in the book that describes the method, Innovation Generation: How to Produce Creative and Useful Scientific Ideas11; the paired workbook, Creativity in the Sciences: A Workbook Companion to Innovation Generation12; and a story book that establishes that creative geniuses actually used such methods, Genius Unmasked.6

OUR HABITUAL WAY OF THINKING

Normal thinking is filtered through what linguists call “frames.” Frames are a structure of expectations and assumptions used to interpret new information. They allow us to think and speak in a common and highly efficient shorthand, which constitutes a ubiquitous set of norms. Frame breaking is surprising and leaves us not knowing how to react. Thus, if I were to enter the classroom in a swim suit and, instead of teaching, I engaged in an hour-long monologue about my summer vacation, it would engender shock, confusion, and likely hostility. Science has many agreed-upon frames, often called paradigms.5 The very scientific method of hypothesis generation and empirical testing is a frame. Without frames, we would constantly have to check our suppositions and, for all practical purposes, this would paralyze progress.

One drawback of frames is that, although they can clarify, they can also confuse. Cognitive biases stem from and reinforce frames. They are systematic mental errors that lead to inaccurate assessments of situations involving numbers, social encounters, and memories. As noted in the Nobel Prize–winning work of Kahneman and Tversky and subsequently popularized in Kahneman’s book, Thinking Fast and Slow,13 biases can lead to choices that are inconsistent or even irrational. Biases direct individuals toward the familiar and away from the novel. Frames more generally, and biases in particular, are fundamentally constraining, a fact discussed a generation ago in the context of paradigms in science by Thomas Kuhn in his groundbreaking book, The Structure of Scientific Revolutions.5 Individuals asked to devise solutions to rising crime in a community were influenced by a brief description of crime.12 When the narrative characterized crime as a contagion, respondents proposed social solutions such as reducing poverty and increasing education.14 When crime was described metaphorically as a beast, participants selected punitive legal interventions.

Innovation, and particularly revolutionary innovation, requires breaking frames. Breaking frames can lead to fundamental reconsideration of scientific belief systems. In the 1950s, lead intoxication, like overdosing on alcohol or aspirin, was considered a medical matter, treatable through chelation and avoidable through appropriate personal precautions.15 Herbert Needleman changed that paradigm by re-envisioning lead as an environmental toxicant, preventable through public health action. Before he conceptualized this frame shift and while still a pediatric resident, Needleman provided the mother of a lead poisoning victim with the standard advice to remove lead paint from her home. The distressed parent replied that she had no financial means to either accomplish lead eradication or to move. It was an impasse that caused Needleman to later note,

I suddenly understood that it was not enough to make a diagnosis and give a drug: the disease was a product of the living situation of poor people in the city.15(p236)

Needleman’s subsequent epidemiological studies linked lead levels in bones and teeth to childhood intelligence and found that worrisomely high lead levels were ubiquitous among the lower-income children of Boston. Lead, he and others concluded, was a common environmental toxicant that could not, in fact, be avoided by Boston’s poor. His work changed the lead paradigm from that of treating individual cases to that of preventing population exposure.

Recognizing frames, the consequences of thinking within frames (such as biases and other constraints), as well as processes for breaking frames are the central concepts in the innovative thinking course. Because frames are typically nonobvious, tools and heuristics are needed to identify and overcome them. For example, the frame for science’s interaction with disease is that of a war: “eradicating,” “eliminating,” “war on cancer.” Yet life extension through eradication of all disease at any cost is not consistent with judicious public health practice. Instead, we balance individual and societal threat versus cost. A more realistic public health frame is one of optimizing quality of life by finding equipoise between benefits and risks. This war frame is something students rarely appreciate spontaneously. The following tools and heuristics assist them in doing so.

OBSERVATION

Science is empirical, and most scientists assume they are perceptive observers. Indeed, great innovators are great observers. But human nature leads us to attend selectively to the things we believe are important; observation is framed. Attention is yet another skill that must be cultivated.

Alexander Fleming, the father of antibiotics, exemplified breakthrough innovation as a result of acute awareness. When one of his petri dishes became contaminated with mold, he did not throw it away as was standard practice.16 Instead, he noticed that around the mold was a green ring wherein no bacteria grew. Further study of the mold’s bacteria-inhibiting action led to the discovery of penicillin. Robin Warren, winner of the 2005 Nobel Prize for the discovery that Helicobacter pylori causes stomach ulcers, noticed small, curved specks within the gastric crypts of affected patients.17 Other pathologists ignored these because the textbooks at the time claimed that the acidic environment of the stomach rendered gastric tissue sterile. After years of unsuccessful attempts to develop an animal model, a colleague with whom Warren shared the Nobel Prize, Barry Marshall, drank a petri dish full of the bacteria. Marshall’s development of peptic ulcer disease provided the proof of principle that led to later discovery of H. pylori, a finding that has made antibiotics the backbone of successful peptic ulcer treatment.

CHANGING POINT OF VIEW

Public health improves the well-being of a wide diversity of communities. Putting ourselves in another’s shoes allows us to jump between our frames and those of people holding divergent assumptions. Community-based participatory researchers try out the point of view of the people with whom they engage.

In their book Poor Economics, Banerjee and Duflo put forth a radical rethinking of the economics of poverty based on field experiments that show a clear logic behind decisions made by residents of impoverished communities.18 Why, they ask, are the suburbs of Tangiers, Morocco, filled with unfinished houses? Because in a society where the poor have insufficient capital to avoid excessive banking fees, this is the safest and most effective way to save money—1 brick at a time. Understanding the point of view of poor people, rather than considering their behavior illogical, paves the way for novel solutions to scarcity.

ANALOGY

Analogy is one of the most commonly used tools to promote innovation as it explains the unfamiliar in more recognizable terms. Blood vessels become like road systems or waterways. Light behaves like a wave on a pond. Moreover, insights from one discipline can be translated to another.

The human mind readily constructs associations. The wider our spheres of association, the more likely 2 webs of connections overlap into an analogy.19 Edward Jenner fashioned the first vaccination by subepidermal injection of cowpox. The analogy between smallpox and cowpox was based on the observation that milkmaids did not become ill during smallpox epidemics. Even though Jenner had no idea how cowpox protected against smallpox, he initiated a bold experiment in 1796, almost 7 decades before Pasteur formally proved germ theory, in which he inoculated an 8-year-old boy with cowpox and subsequently challenged the boy with an inoculation of smallpox.20 When no disease developed, Jenner concluded that the cowpox vaccination had been protective. Analogy today guides public health initiatives such as proposals for a soda tax to prevent obesity based on the success of cigarette taxes for reducing cigarette consumption.

JUGGLING OPPOSITES

Public health research is inductive; it is based on empirical observations that lead to hypotheses and theories. Theoretical mathematics is purely deductive. Deductive reasoning moves from theory to observation; it starts from assumptions that are stated as axioms or givens, and from these draws a logic-based conclusion. Empiric sciences often discourage deductive reasoning as speculative or overreaching. However, many novel ideas spring from admixing induction and deduction. A few kernels of observation lead to a daring and even audacious leap to generating a theory. Only afterward is care taken to go back to prove that theory.

Darwin, for example, used deduction to extend observation. His direct observation was that Galapagos finches had a variety of beak sizes and shapes based on their island of origin.21 By means of a leap of logic, he deduced that this array arose through a process whereby the best-adapted beaks out-competed others for a given environmental niche. He had no direct evidence. Yet he posited the theory of natural selection, an idea with revolutionary consequences that still generates empirical evidence to establish its veracity.

Similarly, Ness and Cottreau’s theory that pelvic inflammation increases the risk of ovarian cancer came from a combination of induction and deduction.22 The empirical evidence was that risk factors such as talc use (talc having a fibrous structure much like asbestos) and pelvic inflammatory disease cause inflammation and have been shown to raise ovarian cancer risk. Protective factors such as ovulation and tubal ligation reduce the risk of inflammation and lower ovarian cancer risk. Putting these patterns together led to a logic-based theory. Several inflammatory mediators have since been linked to ovarian cancer and more are under investigation.

BROADENING PERSPECTIVE

Idea generation can be advanced through taking a broad perspective. Consider the question, “How can we provide more nutritious foods in America’s lunchrooms?” An obvious answer might be to mask wholesome foods in familiar packets, such as offering zucchini fries. Such small steps may or may not have an impact on obesity. Now consider the broader question, “How do we get America to eat better?” This question generates not only ideas but also more questions. These might include: “What is the role of price?” “How are taste preferences for fats and sugars set?” “In making food purchases, what is the role of convenience?” “Why are foods of high nutritional value often more expensive?” “What effect do agricultural subsidies have on food pricing?”

Complex systems theory (á la systems biology) considers such wider questions and the large web of associations that underlie them. From these, predictions are made about mediators, causal pathways, and the theoretical impact of interventions. Broadening the perspective greatly expands the possibilities for generating novelty.

REVERSAL

Reversal works either by flipping assumptions or by realizing the import of a serendipitous twist. Serendipity, appreciating a “happy accident,” is a valuable trigger for innovation; as Pasteur remarked, “chance favors the prepared mind.”23(p79)

Joseph Goldberger, a public health officer, was one of the first to recognize that disease could be caused by a nutritional deficiency.24 When he was dispatched in 1914 to investigate asylum-based outbreaks of pellagra, he believed, as did all scientists, that the devastating condition, which spreads in epidemic form, must be an infection. Goldberger came to question that assumption when he noticed that pellagra did not follow normal patterns of contagion. Only patients, not staff, were affected. Ultimately Goldberger had the radical insight that the disease was not because of the presence of an infectious agent but because of the absence of some nutrient. When he fed patients fresh milk, meat, and vegetables, he cured their pellagra and prevented new outbreaks.

Public health is the converse of medicine in the sense that medicine is the presence of disease; public health is its absence. When public health is working, nothing is happening. Rarely do we turn on the tap in the morning and appreciate the lack of discoloration in our water. Absence is something to which we are oblivious. Prevention behavior such as eating right or daily use of an antihypertensive is hard to maintain because the human mind is not wired to get excited about absence.

RECOMBINATION AND REARRANGEMENT

Humans have a tendency toward what Gestalt psychologist Karl Duncker called functional fixedness. Once we are taught a use for a particular object, we are fixed to that particular use or function. A classic experiment proving the concept of functional fixedness is to give a person these instructions: “Take a candle, a book of matches, and a box of thumbtacks, and attach the candle to a wall.” Most people try to fix the candle with a thumbtack or to melt it to the wall (neither of which works). The trick is to take the thumbtacks out of the box, use the box as a candle holder, attaching the back of the box to the wall with a thumbtack. The need to remove the thumbtacks and to alter the function of the box is what stumps most individuals. Only a slight modification to the instructions: “Take a candle, a book of matches, a box, and some thumbtacks, and attach the candle to a wall” makes the task substantially easier.

Thomas Edison was a master of recombination. Some of his most novel and transformational inventions such as the light bulb and the phonograph were little more than existing inventions modified and merged in some original way.11,25 The design firm IDEO has created a neonatal incubator for the developing world out of old car parts.26 Nanoparticle engineers working with pharmacologists are designing novel systems for drug delivery. Informaticians and social scientists are exploring the role of social networks in behavioral change. Whole fields have sprung from combinations: bioengineering, genetic epidemiology, astrophysics, and neuropsychopharmacology, to name a few.

THE POWER OF GROUPS

Public health has long been a collaborative activity. Discovery builds on what has gone before, and discoverers train the scientists of the future; multidisciplinary teams are considered to be more insightful than individuals.

In the 21st century, the power of social networks, self-organizing collectives, and open source have brought communal scholarship and creativity to a pinnacle. The online encyclopedia Wikipedia, aided by thousands of volunteer contributors and hundreds of volunteer editors, has become a preeminent source for information. YouTube has become the arbiter for creative talent. Linux is a creative operating system fashioned by $1 billion in free man-hours of work.27

Our belief that groups can be smart was experimentally validated only recently. In 2010, Woolley et al. set groups to intelligence tasks to assess the features that make groups most successful.28 It turned out not to be what we might presuppose—the aggregate intelligence of the group. Instead, group intelligence was predominantly determined by their inclusiveness (i.e., their ability to tap the diversity of knowledge and insight).

HOW TO TEACH INNOVATIVE THINKING

The innovative thinking class uses a “reverse-the-classroom” strategy whereby out-of-class time is mostly devoted to learning didactic material from Web-posted PowerPoints and the book, Innovation Generation,11 whereas in-class time is spent providing examples from public health, as well as opportunities for practice and application. Practice involves gaining experience with the tools as well as attributes such as nonjudgment, willingness to challenge convention, mindfulness, and plasticity, all characteristics pervasive among genius scientists.11

One practice assignment, for instance, involves looking at a problem from the points of view of a student, policeman, and politician. Or a counterfactual assertion might be presented, such as “obese people should get paid more,” and the student is asked to defend this position. Or the student engages in contour drawing by tracking along the object’s outline while never looking down at his or her paper. Practice selections come from the hundreds of exercises, categorized to correspond to the tools described previously, available in the book, Creativity in the Sciences. A Workbook Companion to Innovation Generation.12 Application comprises employment of specific tools to promote students’ ability to innovate in solving problems related to their current research or interests. Moreover, groups of students systematically apply the method over the course of the semester to a final project in which they must generate a novel solution to a pressing public health problem.

To further disseminate the program, an online massive open online course through the edX platform (Massachusetts Institute of Technology and Harvard University, Cambridge, MA) is currently being developed as a free and accessible pedagogical tool. The edX curriculum will be useable as a stand-alone course or (better) can be augmented by a local instructor with in-class examples, exercises, and application.

SYNTHESIS

I believe that graduate education in science should entail more context than content. Today information is widely available and disseminated through the Internet. Public health training’s move toward “competency-based education” has the probable result of even further focusing instruction on “content” rather than “context.” What is less often taught is a framework for understanding and using information. This implies that much of the pedagogy employed in public health training should be about judging the quality of content, synthesizing and combining different streams of information, and leveraging information to innovate.

I propose that every public health student be taught methods for how to think and specifically how to think innovatively. This will not make all of us genius innovators. It will, however, open young minds to novel possibilities and at least ensure that when they encounter some uncomfortably disruptive new idea, they will give it the respectful consideration it is due.

Human Participant Protection

Human participants were not involved in the study.

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